NPIMap

Organization Active NPI

Serenity Surgery

  • Surgery Physician
  • Maryville, IL
National Provider Identifier
1356762447
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SERENITY SURGERY
Practice address
2227 Vadalabene Dr
Maryville, IL 62062-5823
Phone
(618) 288-2052
NPI assigned
Dec 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hania Bednarski, D.O.NPI 1528121795
Title
D.O.
Phone
(618) 288-2052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2227 Vadalabene Dr
Maryville, IL 62062-5823

Mailing address

PO Box 527
Maryville, IL 62062-0527
Phone (618) 288-2052

National Provider Directory

National Provider Directory

Locations

2227 Vadalabene Dr
Maryville, IL 62062
Phone (618) 288-7908

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1356762447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 527",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620620527",
            "telephone_number": "618-288-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2227 VADALABENE DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625823",
            "telephone_number": "618-288-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "BEDNARSKI",
        "authorized_official_first_name": "HANIA",
        "authorized_official_title_or_position": "D.O.",
        "authorized_official_telephone_number": "618-288-2052",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.